Rh-Isoimmunization

Rh-Isoimmunization General Information

Rh-Isoimmunization is a medical condition that is also commonly referred to by specialists as Erythroblastosis fetalis. This medical condition can be apparent before the patient’s birth, sometimes leading to the death of the growing fetus. It is considered one of the most dangerous (severe) blood disorders, which can lead to the development of life threatening consequences. The presence of this clinical illness is generally determined by an Rh incompatibility between the blood of the mother and that of the growing fetus. Due to this unfortunate incompatibility, the female’s immune system may trigger a severe response against the red blood cells of the baby. This generally occurs during labor, when the blood of the mother and that of the baby can come into direct contact. If the baby’s blood cells meet the mother’s antibodies, they will be destroyed. In such conditions, the baby is prone to suffer from a severe form of anemia, and several other complications (death or severe brain damage).

The red blood cells are known to contain several types of antigens (proteins). The mother and the father of the baby each pass one antigen (either A, B or O) to their child. There are several ways in which the genes are paired, determining the baby’s blood group. Another common antigen carried by blood cells is the Rh factor; if the patient presents this protein, he or she is Rh positive, while those who do not have this antigen are Rh negative. Rh-Isoimmunization is known to occur when the mother is Rh negative and the child is Rh positive.

Rh-Isoimmunization Symptoms

When the mother’s immune system starts to produce antibodies against her child’s blood, Rh-Isoimmunization may occur. In such cases, the antibodies destroy the baby’s red blood cells, leading to a dangerous form of anemia. In such circumstances, the infant’s organism tries to compensate for his or her lack of red blood cells, through the release of immature red blood cells, which are produced in the bone marrow. The immature red blood cells which are released in such cases are called erythroblasts. If the baby’s organism starts to produce abnormally large numbers of erythroblasts, the infant’s spleen and / or liver may enlarge; immediate medical care is needed in order to prevent irreversible liver damage or even a rupture of the baby’s spleen. Furthermore, as the baby’s organism tries to repair the lack of red blood cells caused by the Rh-Isoimmunization, the infant’s organism diminishes its production of the other types of blood cells. This will eventually lead to a lack of blood clotting factors, which can only complicate the baby’s initial medical condition.

As the baby’s red blood cells are destroyed, they release hemoglobin (the red pigment of the blood). This substance eventually degrades to bilirubin. Although the bilirubin naturally occurs in the organism when the red blood cells die, the body is not equipped to handle an excessive amount of this substance. As abnormally large amounts of bilirubin accumulate in the patient’s organism, he or she will experience hyperbilirubinemia, another symptom of Rh-Isoimmunization. Other common clinical manifestations that may be associated with the presence of this medical condition include: jaundice, low blood sugar, unusually high levels of insulin, hydrops fetalis, heart medical conditions, and so on.

Rh-Isoimmunization Treatment

It is very important for all pregnant females to undergo regular clinical evaluations – especially if the mother may present antibodies against the blood of the developing fetus – in order to prevent the baby from suffering the consequences of Rh-Isoimmunization. The female’s blood levels of antibodies should be carefully monitored; if an increase in the female’s levels of antibodies occurs, ultrasound, blood sampling of the fetal umbilical cord and amniocentesis are only some of the medical procedures that are employed in order to asses the harmful effects of Rh-Isoimmunization on the developing fetus. 

Severe complications will arise if the clinical tests show that the baby’s blood or the amniotic fluid present abnormally high levels of bilirubin or if the presence of hydrops fetalis is indicated by the ultrasound. In such cases, if the physician assesses that the baby is in real danger, he or she may advise the mother to undergo an artificially induced labor, provided that the pregnancy is 32 weeks or more. If the female has not been pregnant for more than 32 weeks, the developing baby may be administered blood transfusions, even if he or she is still in the female’s uterus.

Such a clinical tactic is widely employed in the therapy of Rh-Isoimmunization; it can be achieved through 2 medical techniques. One of them involves the insertion of a needle though the female patient’s abdominal area, through her uterus, reaching the baby’s abdomen. Through this needle, physicians inject red blood cells, which should be immediately absorbed in the infant’s bloodstream. After birth, the physician will have to closely monitor and assess the severity of the infant’s clinical symptoms. If the child is diagnosed with the presence of a severe form of anemia, he or she may be administered one or more blood transfusions, which should provide the organism with sufficient red blood cells. These transfusions are supposed to correct the baby’s abnormal bleeding and his or her hyperbilirubinemia (symptoms that may arise due to Rh-Isoimmunization).

Phototherapy is another medical technique which can be employed in the therapy of hyperbilirubinemia. This treatment trial achieves its purpose as it is able to change the shape of the bilirubin molecule (this is a direct consequence of the light beams), making it far easier to excrete. Other patients diagnosed with the presence of this blood medical condition may be prescribed intravenous fluids rich in the needed electrolytes. Certain medical products may be administered in order to deal with the baby’s clinical manifestations. In most clinical cases, the unpleasant signs of Rh-Isoimmunization can be effectively prevented though the adequate monitoring of the baby’s condition and through thorough blood type screening. However, studies show that even with the modern tests and preventive measures, about 4000 babies from all over the world suffer from this severe condition every year.